HPV: what is it, symptoms, vaccine, treatment, transmission

HPV is a sexually transmitted virus and, due to the lack of protection, high circulation. Many, many patients may have no symptoms and others may have genital warts . There are also types of virus related to cancer of the cervix.

Therefore, prevention and care are essential to protect yourself from HPV and other conditions.

What is HPV?

HPV stands for Human Papiloma Virus  . Also called a cock’s crest , it is the most common sexually transmitted disease (STD) in the world.

Studies show that more than half of sexually active people will contract the virus at some point in their life. In Brazil more than 54% of young people between 16 and 25 years old have HPV.

The virus is eliminated by the body naturally, but in some cases it manages to settle and the disease fixes itself.

There are more than 200 different types of HPV, most of which do not cause problems, while some are capable of causing warts and others are linked to the development of cancer. More than 95% of cervical cancer cases, the most common among women, are linked to HPV.

Types

There are hundreds of different types of HPV. Around 150 of them have already been genetically sequenced. Although the vast majority of them are not dangerous, the most common ones can cause serious problems.

Here we list the main and most common symptoms:

Types 1 and 2

These two types infect the skin, often the hands, feet and face. They can move from one place to another in the body through contact, as well as from person to person. They cause warts.

Type 6 and 11

Types 6 and 11 are more frequent in women and, although there are more than 30 types that affect the genital region, only these two represent 90% of the cases in this area. These types cause warts called condyloma acuminata  on the vulva, penis and anus.

Types 16, 18, 31 and 45

These four types are known to be considered at risk for cancer. Cancers of the vulva, penis, anus, neck, head and cervix are related to these types of the virus. Cervical cancer is especially associated with them, as more than 95% of cases of this type of cancer are related to HPV.

Cervical cancer

Cervical cancer is especially linked to HPV. All instances of this type of cancer have the virus infection. Today, medicine is able to prove that around 95% of cases are caused directly by the virus.

In the other 5%, on the other hand, it is not possible to prove this direct causal relationship. However, as all women who have cervical cancer have the HPV virus, it is more than fair to establish this relationship.

It is worth remembering, however, that not every woman who contracts HPV will develop cancer. In fact, it is relatively rare for the virus to even show itself, especially with the help of preventive treatments.

However, the rule is clear: every case of cervical cancer has the presence of HPV.

Causes

HPV is caused by a virus that affects the basal cells of the skin, but each type can affect the body in a slightly different way. The variation can dictate whether the infection happens on the skin, genitalia or mucous membranes, for example. The virus needs living cells to reproduce.

Streaming

Transmission of HPV can happen through simple skin-to-skin contact. Among the main means of transmission are:

Unprotected sex

The most common method of transmission is unprotected sex. It is estimated that 10% of girls will have contact with the virus at the first sexual intercourse. The disease can affect the genitals, the anus and even the throat through oral sex.

Using condoms is the best method of prevention, since a large portion of the population has the virus without even knowing it.

Direct contact

Contact of the fingers, hands or skin in general with the genitals or healthy parts of the skin is a possible way of transmission, but significantly unlikely, both from one person to another and between parts of the body of the same patient.

Childbirth

It is possible for a baby to contract HPV during delivery if the mother has the disease. If there are vaginal warts at the time of delivery, caesarean section is recommended.

Can objects transmit?

It is possible, although it is much rarer, that objects are contaminated by one person and transmit the disease to another. Sharing underwear, towels or blades, for example, can cause this transmission, but it is very unlikely. The chances of infection are much greater through sex.

Blood

There is a possibility that blood transfusion is capable of transmitting HPV, but if it is true, it is a rare event. The studies carried out to find this relationship were inconclusive since other ways of contracting the disease may have influenced the results.

Risk factors

It is not just sex that can transmit the disease, but this is the main risk factor since in many cases the simple contact can pass the disease of someone who does not know that she has it.

Unprotected sex

Main method of transmission of HPV, having sex without a condom is a factor that greatly increases the chances of someone contracting the disease, especially if unprotected relationships are with different partners, as this increases the chances of having sex with someone infected.

Lack of vaccination

Vaccination for some variations, specifically the main causes of tumors, exists and is made available by SUS for boys between 11 and 15 years of age, in addition to girls under 15.

With the vaccine the protection is 98% against types 6, 11, 16 and 18 of the virus. Not having the vaccine reduces protection, increasing the risk of getting the disease.

Immunocompromised people

HIV , other infections currently occurring (such as herpes), use of drugs that affect immunity, smoking , chemotherapy treatment, use of oral contraceptives for a long time among other things can reduce the effectiveness of the immune system, facilitating an infection with the HPV virus .

Women

Anyone can contract and spread the virus, however symptoms are more common in women. In addition, cervical cancer is one of the most common malignant tumors and affects only women infected with HPV.

Although there are also male cancers related to the virus, they are not so common, so women should be more careful with this disease.

Early sex

The HPV virus sees no difference between someone 12, 15 or 30 years old, so it is not exactly the beginning of early sexual life that puts people at risk.

However, information on sexual safety is more widespread after a certain age, so the younger the person is when they start their sex life, the greater the chances of making mistakes due to lack of information, such as not using a condom. Lack of information is the real risk factor here.

Symptoms

Symptoms of HPV are changes in the skin and mucosal tissue, but the type of variation depends on the version of the virus. The following table shows which symptoms are related to which types.

Symptom HPV type
Common warts 2, 7, 22
Fish-eye calluses 1, 2, 4, 63
Flat warts 3, 10, 28
Genital warts 6, 11, 42, 44 and others
Anal dysplasia (lesions in the anus) 6, 16, 18, 31, 53, 58
Genital cancers High risk: 16, 18, 31, 53, 58
Moderate risk: 33, 35, 39, 51, 52, 56, 58, 59
Probable risk: 26, 53, 66, 68, 73, 82
Verruciform epidermodysplasia More than 15 different types
Mouth papillomas 6, 7, 11, 16, 32
Cancer of the oropharynx 16
Verrucous cyst 60
Respiratory papillomatosis 6, 11

Warts

Warts caused by HPV are called papillomas . They are benign tumors on the skin or mucous membranes and there is a possibility that they will disappear on their own. They are painless and can appear in different places and formats depending on the type of virus, with the hands and mouth being the most common regions.

Another frequent place for the appearance of papillomas is the genital region and the anus. They can appear in the form of simple warts, condylomata acuminata  (an accumulation of warts).

In rare cases it is possible that there is the development of respiratory papillomatosis , which occurs when warts appear in the airways, making it difficult or even preventing breathing, requiring surgery to clear the way.

Cancer

The most serious consequence of HPV is cancer. It is extremely rare for a papilloma to turn into cancer, but these chances increase considerably when the infection is caused by types 16 ,  18 , 31 and 45 , the types considered to be at risk since they have high cancer potential.

They can cause genital cancer, that is, in the penis, vagina and anus. In addition, when they infect the throat, it is possible that they lead to oropharyngeal cancer.

More than 95% of cervical cancers are attributed to HPV infections of these types. Considering that this is the fourth most common cancer in women, the disease is a serious problem.

Verruciform epidermodysplasia

Extremely rare disease, only five people in the world have verruciform epidermodysplasia. It causes papillomas to grow through the body in an uncontrolled manner, creating a layer of warts on the skin that makes it look like a tree bark. People affected by this disease are often called “tree man” because of their appearance.

It is typically caused by types 5 and 8, which are common and are usually harmless. However, patients with this condition have it because of a rare immune system problem that does not defend itself from the virus in any way, leaving it free to affect cells.

How is the diagnosis made?

The diagnosis of HPV does not always happen, since most of the time the body eliminates the virus on its own or has no symptoms, making the person not feel the need to seek a specialist for exams.

However, the doctors who can make this diagnosis are the infectious disease specialist , gynecologist , urologist , general practitioner  and dermatologist .

It is also necessary to do tests to identify the type of HPV, as this is extremely important to know what are the risks of the disease of that specific patient. Check out:

Pap smear

The pap smear exam uses a special spatula to collect cellular samples from the uterus that are then analyzed under a microscope. The pap smear cannot diagnose HPV directly, but it serves to find dysplasias in the cells of the uterus.

Dysplasia is the medical term for abnormality. Normally, dysplasias in the uterus cell are caused by HPV, so they are a very strong sign that the virus is present.

This exam is performed in routine gynecological consultations.

Biopsy

A biopsy is an examination that consists of removing a small piece of tissue on which the suspected infection lies. The piece of tissue is viewed under a microscope in detail, in addition to other tests being done to search for the virus.

Colposcopy

This test consists of applying an acid to the cervix which, after a few minutes, is examined by the colposcope , a device that allows analysis of the tissue affected by the acid. Pre-tumors are visible due to acidity.

Peniscopy

As in colposcopy , peniscopy is the application of acid and observation through a device that will also look for warts too small to be seen without the help of the acid and the device.

PCR genetic test

The PCR genetic test , polymerase chain reaction, from the English “polymerase chain reaction”, uses samples of the virus collected from the warts to identify the DNA of the specific type of HPV infection, as well as by other microorganisms. The result can take up to 5 days.

Is there a cure?

Unfortunately HPV has no clinical cure , but the immune system can deal with the virus most of the time.

Complete eradication of the pathogen is very difficult when the body does not do it spontaneously. Therefore, treatments are performed to reduce symptoms and avoid complications, but recurrence of papillomas is common.

The spontaneous cure of the disease occurs through the action of the immune system. The virus installs itself in the cells, is incubated for a while and then uses them to reproduce, but remains latent during the incubation time.

If the immune system is able to eliminate the virus during this latent phase, the person heals without ever showing symptoms and this is what happens most of the time. It is also possible that this will happen after the symptoms appear. Especially in young people, the disease usually heals in about a year and a half.

With treatment, the immune system is able to eliminate the virus more easily.

What is the treatment?

Treatment for HPV consists of controlling symptoms and monitoring possible cancerous developments for early treatment.

Medicines

Medicines used to treat HPV symptoms can be applied directly to warts. They are capable of destroying papilloma cells.

There are also immunomodulatory drugs . They stimulate the immune system to fight the HPV virus, eliminating the symptoms, but not the virus entirely.

Surgery

Removal of warts through surgery is possible. Scalpel, cryotherapy (freezing the wart) and laser therapy (laser therapy) can be used.

Medicines

The medications that can be used against HPV are as follows:

Topical medications

  • Trichloroacetic acid;
  • Podophyllin;
  • Fluorouracil .

Immunomodulators

  • Imiquimod ;
  • Interferon .

Attention!

NEVER  self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Vaccination

The HPV vaccine is able to protect the patient from the virus. These vaccines are known to be most effective when applied before the age of 15, but that does not mean that it is ineffective in older people. Both boys and girls can be infected, but since the virus is more dangerous for women, there is priority for them.

Types

Bivalent vaccine

This vaccine protects against type 16 and 18 viruses. These two are capable of causing cervical cancer. Girls at any age after the age of 9 can get this vaccine.

Quadrivalent vaccine

This version of the vaccine protects against types 6, 11, 16 and 18 viruses. The first two are primarily responsible for genital warts while the last two can cause cervical (cervical) cancer. The vaccine distributed by the Ministry of Health is quadrivalent and it must be taken in two separate doses for 6 months.

Who should take it?

Girls between the ages of 9 and 14 and boys between the ages of 11 and 14 are the primary target audience for vaccination campaigns by the Ministry of Health. Women with HIV also enter the target audience between 9 and 26 years of age, taking the vaccine in three doses (in this case the second dose is 2 months after the first and the third is six months after the first).

In private clinics, however, the quadrivalent vaccine can be applied to women between 9 and 45 years old and men between 9 and 26. The bivalent vaccine can be applied to women over 9 years old.

Contraindications

The vaccine is contraindicated for patients who are allergic to any component of the formula. It is also contraindicated for those who are allergic to yeasts and for those who have had a strong allergic reaction in a previous dose of the vaccine.

Pregnant women should also wait until the end of pregnancy for vaccination, as no studies have been done in this group and it is not known what results the vaccine can bring to the mother and baby. However, it is known that it is safe to breastfeed after the vaccine.

Side effects

The side effects of the HPV vaccine are known to be weak. Among them are:

  • Redness at the site of the bite;
  • Bruises;
  • Itching;
  • Swelling;
  • Local pain;
  • Fever;
  • Nausea;
  • Pains in the arms and legs.

However, it is important to keep an eye out for allergic reactions. The signs of allergic reaction  are:

  • Shortness of breathe;
  • Wheezing in the chest;
  • Swelling in the eyes, lips, genitals, hands, feet and other parts of the body;
  • Itchy body;
  • Metallic taste in the mouth;
  • Burning and redness of the eyes;
  • Fast heartbeat.

In such cases it is important to go to a hospital to treat the allergic reaction as soon as possible. It is a dangerous reaction and that is why it is important not to get the vaccine if you have allergies to any of its components.

Where to take

It is possible to get the vaccine at health centers. Just take an identity document and vaccination card. In addition, during the campaigns, there are partnerships with schools, where it is possible to receive the vaccination.

HPV vaccination campaign

The vaccination campaign against HPV and Meningitis C is carried out every year by the Ministry of Health, which distributes all the necessary doses for vaccination. They can be found free of charge at health centers, but it is important to remember that even outside the vaccination campaign it is possible to be immunized by SUS.

Living together

Getting a diagnosis of any sexually transmitted disease is not easy. It is important that treatment is performed to relieve symptoms, prevent healthy parts of the body from being infected by contact, and remember to use condoms during sex to prevent the disease from spreading.

Getting in touch with the last people you have had unprotected sex with is extremely important, as it is possible that some of them are infected without knowing it.

Doing frequent tests to check the condition of the infection is recommended for monitoring the disease, as it can heal after some time.

HPV in pregnancy

The greatest risk of HPV for pregnancy is the possibility that the disease will be passed on to the baby during delivery due to the child’s contact with warts on the genital area.

Contamination is rare, but it can happen and usually affects the child’s eyes, hands, feet and mouth. Babies are also more likely to develop respiratory papillomatosis, which is when warts affect the airways.

During pregnancy, warts can get larger due to the amount of hormones and weakened immune systems. It is recommended that symptoms be treated before delivery to prevent the baby from becoming infected.

This treatment, which aims to remove the warts, is usually done before the 36th week so that there is time for recovery. When symptoms appear in the past few weeks, a caesarean section can be recommended to prevent infection from the child.

Prognosis

The disease is frightening, especially due to its connection with cancer and because it is an STD. However, when identified early, its treatment is easy and to avoid the serious consequences as cancer becomes much simpler.

The virus is usually eliminated from the body after some time by the immune system itself, often in the course of a year and a half or two years. In some cases it can stay in the body for a longer time, but this varies from case to case and tests should be done to check if there is still a virus in the body.

It is important to use a condom to avoid passing the virus on to others, but with the right care, there is no need to worry.

Complications

There are some complications due to HPV. The quality of life of the patient can be affected by them, in addition to the physical health of the person when there is no necessary care. Are they:

Aesthetics

Warts are not pretty and, in more advanced stages, can be quite unpleasant from an aesthetic perspective. Without treatment, the infection can cause serious esthetic problems, spreading warts throughout the body.

Contagion

HPV is quite contagious and can be spread through contact with warts and through unprotected sex. When the disease is ignored and the patient continues to have unprotected sex, the virus is spread. Often, without knowing that they have the disease, a person can cause the infection of several people.

Increased risk of cancer

The main complication of HPV is the high chance of cancer. Cervical cancer is closely connected with the virus. Basically, only patients who have HPV develop this type of cancer.

However, this is not the only cancer that can be caused by the virus. In addition to it, cancer of the oropharynx, neck, penis and vulva may appear due to this infection.

How to prevent

A large number of people have the disease without even knowing it, so HPV prevention is very important. Reducing the chances of contracting – and spreading – the disease is necessary and makes all the difference.

Preventive exams

For women, visiting the gynecologist is always positive to keep genital health up to date. The pap smear should be performed annually by sexually active women. After 2 years in a row with no changes found in these exams they can become more spaced out, happening once every 3 years.

If any wart appears on the genital area it is important to visit the doctor to seek treatment for a possible STD.

Keeping the immune system healthy

One of the most important factors, the immune system defines whether or not the virus will be able to install itself in your body. A healthy and balanced diet, exercise, hygiene and frequent visits to the doctor can keep the immune system strong and strong enough to prevent the human papilloma virus from multiplying through your cells.

Condom

The most practical and safest way to avoid any type of HPV is through a condom. Because it is a disease that can be transmitted mainly through sex, condoms are the best way to avoid infection. It does not allow the virus to pass from one body to another.

Vaccination

Getting the HPV vaccine protects your body from the most common and dangerous types of the disease and it is extremely important to stay immunized. The disease is easily transmitted and affects many people, so avoiding contact completely is very difficult. Vaccination ensures that even with contact, the body will be healthy.

Disinfect objects

The use of disinfectants on objects that can be used by more than one person or shared is one way to prevent the transmission of the disease. These objects range from clothing items to sex toys, which must be washed carefully with each use.

Remember: do not use disinfectants on the skin or any other part of the body itself , as they can be toxic and harmful to the skin and mucous membranes.

Common questions

Does the person I have a relationship with also need to be treated?

If the relationship between you and your partner was made without protection, it  is likely that there will also be a need for treatment . However, even with the use of protection, it can be interesting for the partner to perform tests to find a possible infection. Remember that oral sex can also transmit HPV, as well as simple touch – although it is more difficult that way.

Can I get pregnant after HPV diagnosis?

There are no contraindications for pregnancy with HPV, however it is recommended that the disease be treated before becoming pregnant. If not, before delivery. This is necessary because the virus, if it is infecting the vaginal canal, can pass to the baby during delivery.

In cases where treatment is not possible, caesarean section is recommended to prevent transmission of HPV to the baby.

I always use a condom. Am I protected?

The condom one greatly reduces the chances of HPV contraction, but it does not reset it. Vaccination is important even if the use of condoms is constant and the pap smear should not be ruled out.

I got vaccinated. Can I stop doing the pap smear?

No! The vaccine protects against some types of HPV, but not all. The Pap smear is extremely important for the prevention of serious diseases such as cervical cancer that can be caused by several other types of HPV that the vaccine does not protect.

I already have HPV. Will vaccinating cure me?

No, but you can get vaccinated. HPV can stay in the body indefinitely. The cure by the immune system is not guaranteed. Vaccination is not able to cure someone from HPV, but it can weaken the virus, facilitating the service of the immune system and preventing the disease from manifesting itself, even if it never goes away.

Can the vaccine cause infertility?

No. This is a rumor. The side effects of the HPV vaccine are usually mild and affect around 10 to 20% of vaccinated people, passing through completely in a few days. Allergic reactions, which are more dangerous, are extremely rare, affecting only 0.002% of vaccinated people. Really very little.

Infertility cannot happen as a result of the vaccine.


The human papilloma virus is the most common sexually transmitted disease and some of its types can cause cervical cancer, so it can be a very serious disease. Share this text with your friends so they can learn more about HPV!

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